Inferior vena cava graft-enteric fistula after extended hepatectomy with caval replacement.

Addeo, Pietro; Rosso, Edoardo; Oussoultzoglou, Elie; Jaeck, Daniel; Pessaux, Patrick; Bachellier, Philippe · J Vasc Surg · 2012

case_report · Level V

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Abstract

A case of an inferior vena cava (IVC) graft-enteric fistula manifesting with recurrent sepsis 11 years after a right hepatectomy extending to segments I and IV, the extrahepatic bile duct, and IVC followed by chemotherapy and external-beam radiation therapy is described. A preoperative workup revealed graft thrombosis with air bubbles inside the lumen. Laparotomy found a chronic fistula between the graft and the enteric biliary loop. Removal of the graft without further vascular reconstruction, a take-down of the biliary loop, and a redo hepaticojejunostomy were performed successfully. The diagnostic challenges, possible etiology, and therapeutic implications of this case are discussed.

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